December 13, 2001

The Envision discussion brought to light the core values, immediate needs, and long-term aspirations of the School of Nursing. Drawing bright and altruistic students and comprising a faculty of dedicated teachers and researchers who remain active in their nursing specialties, the school has a solid foundation on which to build its future. As it does so, it will expand its capacity to be

		Innovative — The school has the flexibility to move quickly to create new programs in response to the needs of the nursing profession and the nation’s health care system.
		Collaborative — Faculty are open to working with colleagues in other schools and departments to develop new courses and to pursue promising lines of inquiry.
		Service-Oriented — Service is ingrained in the culture of the school and is reflected in the work of the faculty and in the projects students take on, both in their training and in their volunteer activities.
		Research-Oriented — With its thriving and well-regarded doctoral program, the school places a strong emphasis on research and is exploring ways to expand its scholarly capabilities.
		Student-Focused — The school is committed, above all else, to offering an extraordinary student experience that provides not only the tools and technical skills for the practice of nursing but also opportunities to develop leadership abilities.

Meeting the Needs of the Profession
As it educates nurses to be leaders in a health care environment that is ever changing, the School of Nursing pays close attention to the needs of the profession and can retool quickly to help meet them. Today it is working hard to address the national shortage of nurses, which has hit the University Health System as it has many others. In recent years, a substantial number of the school’s graduates have taken positions with the University Medical Center. Although this hinders the school’s efforts to showcase the quality of its graduates nationally, it ensures that the University has the capacity to address the health care needs of the community and the region.

One indication of the school’s flexibility is its effective use of single-course faculty. These are typically first-rate clinicians who teach a single course in their specialties, exposing students to seasoned expertise in a particular area of nursing. Many of the school’s full-time faculty are also actively involved in clinical practice, which further contributes to the school’s ability to train skilled practitioners in its undergraduate and graduate programs. The school’s alumni are known nationwide for their ability to hit the ground running when they enter the profession.

Looking at specific needs in the profession and in society, the school would like to recruit more faculty with expertise in gerontology. This would be a critical step toward creating a nurse practitioner program in geriatric nursing and would help to place a stronger emphasis on geriatrics in the undergraduate curriculum. It would complement recent hires in the School of Medicine aimed at better serving an aging population, and it would help to address a shortage of geriatricians and nurse practitioners who can serve elderly patients in primary care settings and who are vital to managing nursing homes and other assisted-care facilities.

Provost Gene Block observed that the Nursing School’s goals in this area dovetail well with a proposal to create a University-wide institute on aging that would capitalize on research strengths in such areas as cognition, Alzheimer’s disease, and the hormonal processes associated with aging.

The Strength of the Graduate Programs
The doctoral program is one of the prides of the school. Some 40 students are currently enrolled in the program, which admits seven new candidates each year. Many doctoral students continue working during their coursework or return to work upon completing coursework, which makes it difficult for them to devote time to their dissertations. Nevertheless, the program’s participants, by and large, earn their Ph.D.s within seven years.

Described as "the stuff in the middle of the sandwich," the school’s master’s program offers nine tracks, and more are needed to meet the needs of the profession. Four of the school’s graduate tracks are ranked in the top 10 nationally — psychiatric and mental health nursing, the pediatric nurse practitioner program, community health nursing, and acute care nursing. Stretching resources to create more programs that meet the school’s high standards will be a significant challenge.

The school’s graduate programs draw nurses from across the Commonwealth. In fact, 50 percent of master’s-level students live well outside the Charlottesville area, commuting from as far away as Norfolk and southwest Virginia. The school is seeking cost-effective ways to use the Internet to reach these students, and one of the ideas that surfaced in the Envision discussion is collaborating with the School of Medicine to deliver Web-based instruction. Although the Medical School has developed a strong platform for offering courses over the Internet, it was noted that the University as a whole should develop a standard Web platform that would be adaptable for all schools and programs.

The Promise of Collaboration
Much of the Envision discussion focused on current and future possibilities for collaboration with other schools and programs around the Grounds. The promise of such cross-disciplinary endeavors is already evident in the Nursing School’s work in clinical ethics, which involves faculty in such fields as philosophy and religious studies, and in the humanities in nursing project, which contributes to an exciting intellectual environment in the school.

The school partners with the Darden School to offer a joint-degree program emphasizing health care management, and the nursing faculty’s research efforts often involve colleagues in such fields as engineering, economics, psychology, and anthropology. The Nursing School works hand-in-glove with the School of Medicine in a number of areas, among them health evaluation sciences, critical care, and pharmacology. Unlike the many nursing and medical schools that are far removed from the main campuses of their institutions, the School of Nursing has the advantage of being physically contiguous with other units of the University. This is intellectually stimulating for both students and faculty and fosters work across disciplinary lines.

The strong collaborative relationship between the Nursing School and the Medical Center is vital to giving students hands-on training and also provides faculty with opportunities for creativity and growth. Indeed, the school has helped the University Hospital contend with the stresses of reorganization and downsizing in recent times. This mutually nurturing partnership is rare among schools of nursing and academic medical centers, but it can be demanding for faculty who must balance their clinical work with their teaching and research responsibilities. While professionally enriching, clinical activities are not adequately recognized in the University’s faculty rewards system, which places greater weight on research productivity.

With its strong emphasis on community health, disease prevention, and health maintenance, the Nursing School could be a very effective partner with the School of Medicine as it explores the possibility of developing a master’s program in public health. Indeed, it was noted that the Nursing School is well positioned to provide the leadership for the University’s new ventures in the public health field.

Barriers to the school’s collaborative efforts include the lack of a fair mechanism for rewarding faculty who participate in interdisciplinary programs. As one participant pointed out, the University is a consortium of fairly independent schools, and when faculty see opportunities to take part in research and teaching initiatives outside their school boundaries, there is no structure to support them.

Developing New Knowledge in Nursing
The School of Nursing intends to increase its capacity to generate research that is patient-focused and clinically important, although retirements of several senior faculty in recent years have diminished the school’s research funding. As it makes new hires, the school must work to recruit scholars who come with grant funding or whose research holds the promise of attracting external support.

The school has attracted major support for research on complementary and alternative treatments, such as the use of magnets and therapeutic touch to reduce pain.

The school also houses one of only two centers in the nation devoted to research on the history of nursing, and it is committed to maintaining its leadership in this field. To do so, it will need more staff support to manage its growing archival collections.

Another promising area of research is the evaluation of new health care products. This work enables students and faculty to try out the latest innovations in equipment and techniques, it helps manufacturers measure the effectiveness of their products at various stages of development, and it generates revenue for the school.

Training Superb Students
At a time when many nursing schools are cutting back or eliminating their baccalaureate programs, the University’s School of Nursing views the quality of its undergraduate students as one of its key strengths. They enter the school with strong academic credentials and an equally strong desire to serve the common good. Their ethic of caring can be seen in their volunteer efforts, such as Nursing Students Without Borders. Established by students and organized with the help of faculty member Audrey Snyder, the program has sent teams to El Salvador to offer educational programs in sustainability, hygiene, sexual and reproductive health, and first aid. Another group is planning a trip to Russia, and students in the program have provided aid and education to migrant workers in the Charlottesville area. Launched at U.Va. and supported by the participants’ own fund-raising efforts, Nursing Students Without Borders has expanded to two other campuses.

In recent years, the school has attracted a growing number of international students, and their presence has enriched classroom exchanges and has broadened the perspectives of their American counterparts. Fully in sync with the Virginia 2020 international initiatives, the school is working to provide more opportunities for students from the U.S. to study abroad. It already offers a successful program at Oxford.

After earning their bachelor’s degrees, nursing students typically pursue clinical careers for a time before entering graduate school. As a result, the School of Nursing’s graduate students tend to be mature; in fact, the average age of the school’s Ph.D. candidates is 44. To address a growing shortage of nursing faculty nationwide, the school is encouraging students to enter advanced degree programs earlier in their careers.

Students at all levels benefit from ample opportunities to interact with faculty, both within and outside the classroom. Colleagues at other institutions marvel at the open-door policy practiced by faculty at U.Va., and with the help of alumni, the school has created an awards program to sustain its tradition of excellence in teaching. As a result of their involvement with the faculty, graduates maintain a warm and enduring relationship with the school that translates into generous support and volunteer leadership. Thanks to giving from alumni and other donors, the school has vastly increased the amount of scholarship support it can provide. Over the past half-decade, the number of students receiving scholarships has grown from just a handful to more than 150.

Addressing the Challenges of the Future
Among the challenges the School of Nursing must overcome, the most pressing is insufficient space. The school is mounting a campaign to expand McLeod Hall, which would provide the facilities necessary to strengthen research programs, enlarge the faculty, and increase enrollment. As it conducts searches to fill several endowed chairs, the school has found that the lack of adequate facilities is a major hindrance to recruiting faculty who are leaders in their specialties.

Another roadblock to progress is a shrinking nationwide pool of qualified faculty. Finding nursing professors who meet the school’s requirements — ability to engage exceptionally bright students, proven research capacity, and active clinical practice — is a tall order. Although the school offers a wonderful quality of life and a lively intellectual community, it finds it increasingly difficult to locate and hire faculty who combine these traits. Furthermore, there are limited professional opportunities for trailing spouses in Charlottesville, which makes hiring all the more challenging. The school is committed to increasing the diversity of its faculty, in part to ensure that the nurses it trains are able to reach out to underserved populations. This, too, has proved difficult due to the small pool of available candidates.

The Nursing School’s faculty is currently very stable and is made up largely of teachers, scholars, and clinicians at mid-level in their careers. There is a need to bring in promising young scholars to whom the current faculty can "pass the torch." Also needed are eminent professors who can enhance the school’s research base and serve as mentors to junior faculty.

Asked how they would apply a transformational gift from a donor, participants said they would use the funds to create or enhance programs in such areas as

		Rural health
		Chronic illness in an aging population
		Health promotion and disease prevention
		Practical ethics
		International programs, especially efforts to train future leaders in nursing in the developing world
		Emerging infectious diseases, including diseases spread by bioterrorism

In many of these areas, it was noted, there are abundant opportunities for collaboration with the School of Medicine, Arts & Sciences, and other areas of the University. The Nursing School wants to ensure that it has "a place at the table" when the University and the Health System develop plans for the future, and these proposals provide a sense of the vision the school can bring to such deliberations.

Fulfilling a Challenging Mission
The Envision discussions revealed that the School of Nursing expects and receives a great deal from its faculty and its programs. The school seeks to provide a nurturing environment for undergraduates while also offering nationally ranked graduate tracks for its master’s and doctoral students. The faculty strives to maintain close ties to students while also conducting groundbreaking research and remaining on the cutting edge of clinical care. The school finds it a challenge to cover all of these bases, due in large part to its modest size and the limitations of its facilities.

With additional faculty and adequate space, and with the removal of barriers that hinder its collaborative ventures, the school will be better able to fulfill not only its own aspirations but also those of the University. It has the potential to be an invaluable partner in the University’s efforts to enhance its public service and outreach activities, to increase its international presence, and to become a more productive source of basic and clinical research.

Participants:

Jeanette Lancaster, PhD, RN, FAAN, Professor of Nursing and Dean
Doris Greiner, PhD, RN, Associate Professor of Nursing and Associate Dean for Academic Programs
Ann Hamric, PhD, RN, Associate Professor of Nursing; Director, Master's/Post-Master's Program
Barbara Parker, PhD, RN, FAAN, Professor of Nursing; Director, Center for Nursing Research; Director, Doctoral Program
Judy Sands, EdD, RN, Associate Professor of Nursing and Director, Baccalaureate Program
Catherine Kane, Associate Professor of Nursing and Associate Professor of Psychiatric Medicine; Chair, Family, Community, and Mental Health Systems Division
Richard Steeves, PhD, RN, FNP, FAAN, Associate Professor of Nursing
Debra Lyon, PhD, RN, FNP, Assistant Professor of Nursing
Linda Davies, MSN, RN, Assistant Vice President for Health System Development-Nursing and Assistant Professor of Nursing
Arlene Keeling, PhD, RN, Associate Professor of Nursing; Co-Director, Center for Nursing Historical Inquiry; Director, Acute Care Nurse Practitioner Program
Shelley Huffstutler, DSN, RN, CFNP, Associate Professor of Nursing; Director, Primary Care Nurse Practitioner Program
Sharon Utz, PhD, RN, Associate Professor of Nursing; Chair, Acute and Specialty Care of Adults Division
Elizabeth Merwin, PhD, RN, FAAN, Associate Professor of Nursing and Associate Professor of Health Evaluation Sciences; Director, Southeastern Rural Mental Health Research Center
Clay Hysell, Assistant Dean for Graduate Student Services
Brian Prescott, Dean Lancaster's Administrative Intern
Karen Ratzlaff, Director of Alumni Affairs and Donor Relations, Health System Development-Nursing

Observers:

Russ Linden, Facilitator
Gene Block, Vice President and Provost
Bob Sweeney, Senior Vice President for Development & Public Affairs
Laurie Pohl, Chief of Planning
Robert M. Carey, Dean of the School of Medicine
Lynda Phillips-Madson, Associate Dean, School of Continuing & Professional Studies
Linda Watson, Director, Claude Moore Health Sciences Library
Alex Johnson, Vice Provost for Faculty Recruitment
Bill Sublette, Director of University Publications and Development Communications
Jenny Wyss-Jones, Special Assistant to the SVP for Development & Public Affairs
Doris Glick, RN, PhD, Associate Professor of Nursing
Barbara M. Brodie, RN, PhD, FAAN, Madge M. Jones Professor of Nursing and Director of the Center for Nursing Historical Inquiry
Ann Gill Taylor, RN, EdD, FAAN, Betty Norman Norris Professor of Nursing and Director of the Center for the Study of Complementary and Alternative Therapies
Mary Ropka, RN, PhD, FAAN, Associate Professor of Nursing and Health Evaluation Sciences
Pamela Kulbok, RN, MS, DNSc, Associate Professor of Nursing
Cindi Sanborn, RN, MN, CDE, Director of Annual Giving and Major Gifts
James A. Knight, Associate Vice President for Health System Development